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Unexplained abnormal vital signs on discharge / unexplained deaths after discharge: what can we do better?

Death after discharge from the Emergency Department (ED) is an uncommon but nonetheless highly concerning event. Discharge from the ED, on the other-hand, is a frequent event, with over 80% of ED visits culminating in discharge to home or non-acute care. (1) That number may be increasing with more pressure to find alternatives to inpatient admissions. (1,2) Discharge from the ED is a vulnerable time for patients, and it is a high-stakes time for both patients and providers.